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0554T B1 str & fx rsk analysis

What 0554T is

CMS fee schedule short descriptor: B1 str & fx rsk analysis.

Full CPT long descriptions are licensed by the American Medical Association and are not published on this site; the short descriptor above is the one CMS prints in its own fee schedule file. See About CPT.

Medicare payment for 0554T (CY2026)

This code has no Physician Fee Schedule rate: Carrier-priced - the Medicare contractor sets the price. It may be paid under a different fee schedule (clinical laboratory, DMEPOS, anesthesia) or not paid at all - check the relevant CMS schedule.

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Medically Unlikely Edit (MUE)

Medicare caps 0554T at 1 unit per date of service for practitioner claims (MAI 2 - date of service edit (absolute): units above the MUE never pay), rationale: Code Descriptor / CPT Instruction. Units above the cap are denied unless the edit's adjudication rules allow an appeal with documentation.

Billed with 0554T? These codes are bundled into it

0554T is a Column 1 code in 4 active NCCI PTP edits. When one of these Column 2 codes is reported on the same date of service, it is denied as bundled - unless the edit's modifier indicator is 1 and documentation supports a distinct service with an NCCI-associated modifier.

Column 2 codeShort descriptionModifier indicator
0555TB1 str&fx rsk transmis data0 - no modifier bypassCheck pair
0556TB1 str & fx rsk assessment0 - no modifier bypassCheck pair
0557TB1 str & fx rsk i&r0 - no modifier bypassCheck pair
0743TB1 str & fx rsk vrt fx assmt0 - no modifier bypassCheck pair

0554T is bundled into these codes

0554T appears as a Column 2 code in 3 active edits. Reported with one of these Column 1 codes on the same date of service, 0554T is the code that denies.

Column 1 codeShort descriptionModifier indicator
0691TAuto alys xst ct std vrt fx0Check pair
0749TB1 str&fx rsk assmt dxr-bmd1Check pair
0750TB1 str&fx rsk asmt dxrbmd1vw1Check pair

Data: CMS CY2026 Physician Fee Schedule RVU file (October release, RVU26D) and Medicare NCCI PTP practitioner edits v32.3 (2026 Q4). Verify against the official files before billing or contracting decisions.